HomeMy WebLinkAbout2013, 04-11 Permit App: BLD-2013-0625 Remodel*Wane
�Valley�
•
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcentersooka nevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
ID NEW CONSTRUCTION ADDITION/REMODEL ID ACCESSORY BUILDING
El DECK 0 OTHER
SITE ADDRESS: / jO q 5
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME:
NAME: '2 11/ (2/1
ADDRESS: / )Q c% C314)(":"-a--
CITY:
.WK".►2-
CITY: S "Die -Aid (- STATE: W 1/''
PHONE( () 99(-- o 2c
FAX: 2-o'i -10‘
Zip: 9 / t.0 6
CELL:
CONTACT NAME: JJN V"/
PHONE: l CJ!f I- S 7' FAX: - 9Q(' 3
CONTRACTOR NAME: I 7
CELL:
MAILING ADDRESS: 1-0q-2.,, C / .2/5 t f 3 ��� /
CITY: 5 0 4,,e_ STATE: ct/�1/f/ ZIP: 9/ Zc) t7
PHONE: (col)
q q (— G S� 7 3 FAX: 7,,,<, "'S'0 CELL:
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CONTRACTOR LICENSE No.: ( CEXPIRES: 7fz,,f)1 CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
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****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished B smint SQ
FT: 3
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
(/
30% Slopes on
Property:
No. of Bedrooms:
Construction Typo:
Heat Source:
Se , - r)or Septic:
TOTAL COST OF PROJECT: $ - , ( Ute �j
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit Is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit Inure to the property owner. 3) The signatory Is the property
owner or has permission to represent the property owner in this transaction. 4) All construction Is to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information ma be required to be submitted and subsequently approved before this application can be processed.
Signature
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_-_Residential_11-11-11.doc
Date: 41rlf !�